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Public Statements

Statements on Introduced Bills and Joint Resolutions

Floor Speech

Location: Washington DC


Mr. ROCKEFELLER. Mr. President, I am pleased to join today with my colleagues, Senator Franken, Senator Lugar, Senator Collins, Senator Shaheen, Senator Wyden, Senator Blumenthal, and Senator Brown of Ohio, to introduce an important piece of bipartisan legislation, the Medicare Diabetes Prevention Act of 2012. Our legislation makes a wise investment in seniors' health by extending the proven success of the National Diabetes Prevention Program to Medicare. Nearly 26 million American adults have diabetes, and if this disturbing trend doesn't stop, over half of the adult population will either have Type 2 diabetes or its precursor, ``prediabetes,'' by 2020.

Sadly, my home State of West Virginia has one of the highest diabetes rates in the Nation. In 2009, approximately 174,000 adults, which is 11 percent of West Virginia adults, had diabetes. According to Centers for Disease Control estimates, as many as 50 percent of the nearly 380,000 people with Medicare in West Virginia may be at risk of developing this serious, but preventable, illness. If current trends continue, one in three children born in West Virginia after the year 2000 will develop diabetes within his or her lifetime and people with diabetes risk developing terrible complications down the road, including heart disease, stroke, blindness, and amputations.

Diabetes is also one of the main cost drivers in our health care system. The direct economic burden of diabetes was $116 billion for medical expenses and indirect costs totaled $58 billion due to disability, work loss, or premature death in 2007. The costs associated with this preventable disease for Medicare beneficiaries are expected to grow to $2 trillion over the 2011 to 2020 period.

We simply cannot stand idly by in the face of such overwhelming statistics--and fortunately, there is a way to prevent Type 2 diabetes. The National Diabetes Prevention Program, NDPP, is an innovative approach that has demonstrated its effects in preventing the onset of Type 2 diabetes. The NDPP is a proven, community-based intervention that focuses on changing lifestyle behaviors of prediabetic overweight or obese adults through activities that improve dietary choices and increase physical activity in a group setting. In a large-scale clinical trial that has been replicated in community settings, NDPP successfully reduced the onset of diabetes by 58 percent overall and 71 percent in adults over 60.

Because of the impressive success of the National Diabetes Prevention Program, I believe our seniors should have access to its benefits. The Medicare Diabetes Prevention Act of 2012 will help seniors prevent Type 2 diabetes by allowing Medicare to provide the National Diabetes Prevention Program through community settings like the YMCA, local health departments, or even the local church, reaching people with Medicare wherever they live. In the past, physicians have had few tools for their patients who are found to be at risk of diabetes. Under this bill, if a senior is found at risk for diabetes, for example, through their annual wellness visit, their doctor will be able to refer them to an NDPP program in their area.

Unlike Medicare, which needs a Federal legislative change to cover this program, State Medicaid programs already have the authority to pay for this innovative initiative, and it is my hope that more states will do so. By 2020, Medicaid is expected to cover 13 million people with diabetes and about 9 million people who may have pre-diabetes, and states will spend an estimated $83 billion on individuals with diabetes or pre-diabetes. The National Diabetes Prevention program presents an opportunity for States to reduce the incidence of diabetes among individuals enrolled in their Medicaid programs, an especially strategic investment when combined with the expansion of the Medicaid program under health reform.

The coverage of proven solutions under Medicare is nothing new. Yet, rather than providing a traditional drug or procedure, NDPP allows at-risk individuals to change their lifestyles through a community intervention. Implementing NDPP is a unique response to the alarming and escalating rates of diabetes. This public health solution has demonstrated tangible results that can enable our country to prevent diabetes, while reducing health care costs. The NDPP is a strategic and cost-effective intervention that costs less than $500 per person to deliver, compared to the estimated $15,000 per year spent on each Medicare beneficiary with diabetes. According to the Urban Institute, implementing the NDPP nationally could save $191 billion over the next 10 years, with 75 percent of the savings, $142.9 billion, going to the Medicare and Medicaid programs.

Better yet, the National Diabetes Prevention Program is a job creator, bringing diabetes trainers to more communities nationwide to provide the program. West Virginia has already received funding from the Centers for Disease Control and Prevention through a Community Transformation Grant that will allow the State to train at least 100 community health workers to help disseminate the Diabetes Prevention Program in the State over the next 5 years.

The Medicare Diabetes Prevention Act has been endorsed by the American Diabetes Association, American Heart Association, American Public Health Association, National Association of Chronic Disease Directors, National Association of State Long-Term Care Ombudsman Programs, National Council on Aging, Novo Nordisk, Trust for America's Health, the YMCA of the USA, and State YMCA affiliates in over 45 States. With so many Americans at risk for developing diabetes and its potentially severe complications, today is the right time for Medicare to extend the proven National Diabetes Prevention Program as a covered benefit to seniors.

I urge my colleagues to support this timely and important piece of legislation.


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